The link between alcoholism and affective disorders.

The authors reviewed the family histories of 156 patients in an affective disorders program and identified two groups of affective disorders. Group 1 consisted of bipolar illness and major depression, with high familial incidence of affective disorder and low familial incidence of alcoholism. Group 2 consisted of dysthymic disorders and secondary depression, with low familial incidence of affective disorders and high familial incidence of alcoholism. These findings do not support the common assumption that primary affective disorders and alcoholism are closely linked. The authors discuss the implications for diagnosis of depression associated with alcoholism.

Neurotoxicity with combined use of lithium and thioridazine.

Four cases on a combination of lithium and thioridazine developed severe neurotoxic symptoms, e.g., delirium, seizures, encephalopathy and grossly abnormal EEG's. All patients had been on lithium without thioridazine prior to and after the neurotoxic episode with no complications or EEG changes. The possible risk of combining lithium and neuroleptics (thioridazine) is discussed and repeated EEGs are recommended as a preventive measure.

High referral success rates in a crisis center.

The standard method of referral used by workers at the Cleveland Suicide Prevention Center is to call the facility or therapist to make an appointment for the client and then to follow up to see if the client kept the appointment. Three different patient samples were studied to find what percentage of patients were actually seen at the resource to which they were referred. The success rates were 69.5%, 63.4%, and 62.3%. The authors review some of the literature on referral rates and report that their rates are significantly higher than those reported by screening agencies that merely direct clients to another resource.